Prediction of death and neurologic outcome in the emergency department in out-of-hospital cardiac arrest survivors.
We reviewed the hospital records of 127 consecutive patients who were resuscitated from cardiac arrest in a retrospective cohort analysis. A cardiac arrest score utilizing time to return of spontaneous circulation, systolic blood pressure at the time of presentation, and initial neurologic exam were calculated. This score was analyzed with 39 other clinical variables for significance with regard to mortality or neurologic survival using multivariate analysis. Combining these variables into a cardiac arrest score (levels 0, 1, 2, 3, from least to most favorable) allowed prediction of neurologic outcomes and mortality from a single variable in an independent fashion (p < 0.0001). Logistic regression models found scores of 0, 1, 2, and 3 predicted in-hospital mortality rates of 90%, 71%, 42%, 18%, and neurologic recovery in 3%, 17%, 57%, and 89%, respectively. The cardiac arrest score was able to predict in-hospital mortality and neurologic outcomes in those who survived to emergency department arrival. This scoring scheme may aide in selection of patients for early aggressive measures, including triage coronary angiography and angioplasty.
Thompson
R J
RJ
Department of Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA.
McCullough
P A
PA
Kahn
J K
JK
O'Neill
W W
WW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001925:Brain Damage, Chronic / Q000209:etiology*; D004636:Emergency Service, Hospital; D005260:Female; D006323:Heart Arrest / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012151:Resuscitation / Q000592:standards*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome